A 64-year-old women had suffered from erythema on legs, fever and Raynaud's phenomenon, being diagnosed to have neoplastic angioendotheliosis (NA) by skin biopsy, and was induced to complete remission by CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) therapy. CHOP and subsequent COP therapy were continued for one year. About one year after the last therapy, she was admitted again because of fever.
She was alert but slow in movement and emotionally flat. Laboratory data showed hypoxia without hypercapnea, elevated serum lactic dehydrogenase, mild anemia, increased C-reactive protein, beta 2-microglobulin and ferritin, and positive reaction for RA. Chest X-ray revealed multiple nodular lesions in all the lung fields. The surface-marker analysis of the cells filling small vessels of the lung indicated the monoclonal proliferation of B cells. After CHOP therapy started again, fever disappeared, hypoxia, acidosis and pancytopenia improved, and her mental activity and personality became close to normal. The multiple nodular lesions in lungs had disappeared on the 6th day of the chemotherapy.
These studies suggest that NA is a B-cell lymphoma and causes multiple nodular lesions in lungs as a rare complication.
